Does Sober Living Work? The Experts Weigh In

Does Sober Living Work?

After rehab or detox, recovering addicts who are looking to maintain their sobriety often look for additional resources. Options for continuing support and treatment usually come down to halfway houses or sober living environments. So does sober living work?

A great study by the US National Library of Medicine National Institutes of Health was undertaken back in 2015 to explore whether or not sober living environments work.

The study was the first examination of sober living house residents using a longitudinal design. To date, previous papers had looked at findings in terms of the types of improvements residents make and factors associated with outcome. In this particular study, one of the goals was to look at the significance from the perspective of how sober living homes (SLH) might impact various service systems in the community. The promising outcomes for SLH residents suggest that sober living environments might play more substantive roles for persons: 1) completing residential treatment, 2) attending outpatient treatment, 3) seeking non-treatment alternatives for recovery, and 4) entering the community after criminal justice incarceration.

Before you seek an answer to the question “does sober living work” or attempt to search for “sober living near me”, you must first understand what a sober living environment really is.

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Characteristics of Sober Living Environments

Sober living houses are structured in a way that avoids some of the limitations of halfway houses. The essential characteristics include: 1) an alcohol and drug free living environment for individuals attempting to abstain from alcohol and/or drugs, 2) no formal treatment services but either mandated or strongly encouraged participation in 12 step self-help groups such as Alcoholics Anonymous (AA), 3) required compliance with house rules such as maintaining abstinence, paying rent and other fees, participating in house chores and attending house meetings, 4) resident responsibility for financing rent and other costs, and 5) an invitation for residents to stay in the house as long as they wish provided they comply with house rules.

SLHs have their origins in the state of California and most continue to be located there. ). It is difficult to ascertain the exact number because they are not formal treatment programs and are therefore outside the purview of state licensing agencies. However, in California many SLHs are affiliated with coalitions or associations that monitor health, safety, quality and adherence to a peer-oriented model of recovery, such as the California Consortium of Addiction Programs and Professionals (CCAPP) or the Sober Living Network (SLN). Over 24 agencies affiliated with CAAPP offer clean and sober living services. The SLN has over 500 individual houses among its membership.

While some SLHs use a “strong manager” model where the owner or manager of the house develops and enforces the house rules, contemporary SLH associations such as CAAPP and SLN emphasize a “social model approach” to managing houses that empowers residents by providing leadership position and forums where they can have input into decision making. Some houses have a “residents’ council,” which functions as a type of government for the house.

The Basis of the Study

The lack of a stable, alcohol and drug free living environment can be a serious obstacle to sustained abstinence. Destructive living environments can derail recovery for even highly motivated individuals. Sober living houses are alcohol and drug free living environments for individuals attempting to abstain from alcohol and drugs. They are not licensed or funded by state or local governments and typically, the residents themselves pay for costs. The philosophy of recovery emphasizes 12 step group attendance and peer support. 300 individuals entering two different types of sober living homes over an 18 month period were studied.

Data Collection Sites

The study was designed to assess outcomes for 300 individuals entering two types of SLHs: 1) Options Recovery Services (ORS) in Berkeley, California, which was an adapted model of SLHs in that the houses were associated with an outpatient treatment program and2) Clean and Sober Transitional Living (CSTL) in Sacramento County, California, which consisted of freestanding houses that were not affiliated with any type of treatment.

The Findings

Retention of residents in the sober living environments was excellent. Average lengths of stay in both types of sober living houses surpassed the National Institute on Drug Abuse recommendation of at least 90 days to obtain maximum benefit. The average length of stay at ORS was 254 days (se=169 days) and at CSTL it was 166 days (se=163).

As hypothesized, there were two patterns of outcome for the primary outcome variables. One pattern was that residents reduced or stopped their substance use between baseline and 6 month follow up and then maintained those improvements at 12 and 18 months. This was the case for both substance use measures that assessed 6 month period of time: 1) complete abstinence over the 6 months and 2) maximum number of days of any substance use during the month of highest use. For example, at ORS 6-month abstinence rates improved from 11% at baseline to 68% at 6- and 12-months. At 18 months abstinence was a bit lower, (46%) but still significantly better than the time period before they entered the houses. For CSLT, abstinence improved from 20% at baseline, to 40% at 6 months, 45% at 12 months and 42% at 18 months.

It was noteworthy that a wide variety of individuals in both programs had positive outcomes. There were no significant differences within either program on outcomes among demographic subgroups or different referral sources. In addition, it is important to note that residents were able to maintain improvements even after they left the SLHs. At 12 months 68% had left ORS and 82% had left CSTL.

By 18 months, nearly all recovering addicts had left, yet improvements were for the most part maintained.

There were also improvements noted on the secondary outcome measures. At CSTL these included improvements on employment, psychiatric symptoms, and arrests. The pattern was again significant improvement between baseline and 6 months that was generally maintained at 12 and 18 months.

At ORS there were similar patterns of improvement on employment and arrests. From baseline to 6 months the average score on the ASI employment scale improved from 0.61 (se=0.02) to 0.51 (se= 0.03) and was maintained at 12 and 18 months. The odds of being arrested were reduced from baseline to 6 months by 80% and even further reduced at 12 and 18 months.

Conclusion

Many individuals attempting to abstain from alcohol and drugs do not have access to appropriate housing that supports sustained recovery. The study mentioned above found positive longitudinal outcomes for 300 individuals living in two different types of SLHs, which suggests they might be an effective option for those in need of alcohol- and drug-free housing. Improvements were noted in alcohol and drug use, arrests, psychiatric symptoms and employment. Owners and operators of SLHs should pay attention to factors that predicted better alcohol and drug outcomes, including higher involvement in 12-step meetings, lower alcohol and drug use in the social network, and lower psychiatric severity.

In Plain English

The study showed that recovering addicts who stayed in a sober living environment for 160-250 days were far less likely to relapse, had better employment rates, better mental health and far fewer arrests than those who did not stay at a sober living house.

If you’re in need of a sober living environment, your “sober living near me” search is officially over. With sober living homes across Orange County, we’ll help you get one step closer to sobriety. Contact us today.

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